The Quiet Room’s Preseason Injury Rundown – Introducing “The Gag"

This year’s preseason injury report is taking a new form, and we’re introducing a new term. Much like the Montoya Line is the standard for average goaltending against which all other goaltenders are measured, the Gagner is the standard for hurlworthy injuries against which all other injuries will now be measured.

Sam Gagner horrified the world last week when he tweeted a picture of the fallout from a Zack Kassian high stick to the face.

Broken jaws are nothing new (just ask Sidney Crosby), but Gagner took an already disgusting injury to new highs (lows?) with this picture. My reaction on twitter?

There’s not much that shocks me any more, but that picture certainly did it. The mangled teeth, the face that’s about twice as long as it should be, the second chin on the left side of his face. That tweet set off a chain of events that led to the creation of the Gagner, Backhand Shelf’s newest comparison standard. The lovely and talented Luke Peristy, who writes for Bonks’ Mullet came up with it, and hopefully won’t sue me graciously agreed to let me use it here.

This week we’ll take a look at a few of the more disgusting injuries, complete with their Gagner score. We’ll also have a quick rundown of some injuries that may not be Gagworthy, but could have a significant impact on their teams’ start to the season.

Sam Gagner – 1.0 Gags

Obviously the Gagner’s namesake deserves inclusion. Zack Kassian’s stick broke Sam Gagner’s jaw in two places, knocked out some teeth, and will be keeping him off the ice for at least six weeks. His mouth wasn’t wired shut (which is good, because that’s unbelievably gross), but he did have a surgical repair and will be enjoying a fine variety of puréed foods for a while. He’ll also have a gap in his smile until he can have a partial bridge made or some teeth implanted, but hopefully his extra chin will go away before he posts another selfie.

Joni Pitkanen – 0.475 Gags

Pitkanen broke his heel last April racing for the puck (hybrid or no-touch icing now, please), and his injury is one that keeps on giving. In early September the Hurricanes announced he’ll miss the entire 2013-14 season because of a delay in healing. The calcaneus (aka heel) is very complicated, and very hard to fix. The calf muscles are attached to it via the achilles tendon, as are an actual buttload of ligaments that are integral to a functional ankle joint. Now imagine you’ve broken your calcaneus in eight places, and you’re a professional athlete. Bad news bears.

They’re in red because they’re really frigging important.

While a broken bone doesn’t seem that disgusting if it’s not poking through the skin, this is a broken bone that had to be surgically reconstructed and still isn’t worth a crap almost six months later. Three months of no weight-bearing is expected. A full recovery (in someone who isn’t an NHL defenceman) should take about six months. Pitkanen is six months in, and not bearing weight. A CT scan in early September supposedly showed the surgery was a success, and yet was bad enough to make this entire year a write-off (I haven’t figured that out yet). The problem with this injury isn’t just that Pitkanen is trying to knit back together a shattered bone, it’s that he’s trying to knit back together a shattered bone that bears the brunt of his body weight, makes up a large part of the ankle joint, and is a pain in the butt to heal for the average person, let alone someone who makes their living on skates. This one gets 0.475 Gags strictly by merit of being gross/painful to think about, and more importantly because it could well herald the end of Pitkanen’s career.

Dalton Prout – 0.3 Gags

Prout is a Blue Jackets defenceman who has a disgusting injury, and a flair for words in describing it. He tore an abdominal muscle off his pelvis while training over the summer, which is gross. Take a moment and let that sink in. He didn’t just tear an abdominal muscle, he ripped it right off his pelvis. Ripped it off the bone. He described the repair in the following manner in an interview with the Columbus Dispatch, which is grosser:

“The sutures are like Kevlar,” he said. “You could hang an elephant from them. But you need the muscle to attach completely before you’re ready.”

Hang an elephant from them? Did he seriously just paint a picture of an elephant hanging off the sutures holding his abs onto his pelvis? Dude. Gross.

Tomas Vokoun – 0.45 Gags

Vokoun is no stranger to deep vein thromboses (DVTs), which are big blood clots that generally occur in the lower leg, and can lead to serious complications (like breaking loose, getting stuck in the lung, and killing you). DVTs can happen for several reasons – blood clotting disorders, long periods of immobility, trauma. In Vokoun’s case, it was suggested that the cause was a femoral catheter (like an enormous IV) placed after a burn sustained when he was ten months old. Ray Shero has said that there’s been no confirmation that this clot is related to the last one in 2006,  but damage to the endothelium of a vein (the lining) is a known contributor to thrombosis. Having said that, most catheter-related thromboses happen when the catheter is in place or shortly thereafter. In Vokoun’s case there was a thirty-year gap.

In 2006 while with the Predators he missed the end of the 2005-06 season when blood clots were found in his abdomen and pelvis on an MRI. He spent three months on blood thinning medications, but returned none the worse for wear. This time Vokoun noticed swelling in one of his legs before a preseason game against the Blue Jackets, and quickly ended up in the hospital. His clot was iliofemoral – meaning it was very high (ie in the pelvis), and that’s unusual. DVTs are usually in the lower leg, and usually treated with anticoagulation alone. In Vokoun’s case, he ended up having PMT, or percutaneous mechanical thrombectomy. Simply put, doctors stuck a catheter in his groin, broke up and sucked out his clot. There’s a few kinds of catheters – Some use rotating wires, some use jets of saline, some use ultrasound, and all sound and look scary as hell.

Unclogs plumbing! And pelvic veins!

Vokoun will still require anticoagulation, but the point of the procedure was to take out the huge clot that was keeping all the blood in his leg from getting out. The anticoagulation doesn’t get rid of clot, it just keeps new clot from forming while the body reabsorbs what’s already there. In his case the clot was so big and so close to the important bits (the lungs) that a little extra vein plumbing had to happen. Not visually disturbing, but the thought of rotating wires with jets of saline INSIDE YOUR GROIN should bother you at least a bit.

Other Injuries to Worry About

Nathan Horton‘s shoulder is still screwed up. He had reconstructive surgery in July, which has him out until sometime between November and January (and all points between). Sorry, Columbus. As usual it sucks to be you.

Ryan Nugent-Hopkins also has a screwed up shoulder. He’s supposed to be back in action for the Oilers in early November but he’s been hinting that he might be back sooner. Hey, can someone ask Ryan Kesler how well coming back early tends to work out?

Montreal’s Alexei Emelin has taken it easy on his face for once, and buggered up an entirely new body part. He had knee surgery in May, and is scheduled for a December return.

Jaromir Jagr is old.

Cal Clutterbuck (who plays for the Islanders, a fact I somehow completely missed) suffered a laceration to the leg in a preseason game in Calgary, and is out until early November. Eugene Melnyk is investigating.

Martin Havlat‘s groin isn’t ready for the start of the season in San Jose, and nobody is surprised. He had his pelvic floor reconstructed, which is a really, really big deal. Considering this is a guy who once hurt himself hopping over the boards, I think we need to make sure he takes all the time he needs on this one so his guts don’t fall out through his pelvis.

Mattias Ohlund has awful knees :((((((

GUYS GUYS GUYS HOCKEY STARTS SOON!